Some of the most significant and pervasive public health problems in the US are linked to driving under the influence of alcohol by drinkers of all ages and to underage alcohol consumption. Alcohol is the drug of choice for American youth, although it is illegal for those under the age of 21 to purchase. In 2004, roughly 28.7 percent or 10.8 million youth age 12 to 20 reported having had a drink in the past month (Substance Abuse and Mental Health Services Administration, 2007). Although youth of these ages drink less often than the 6 days per month that the average adult drinks, when they do drink youth drink more (a per-occasion average of 5 versus 2.5 drinks of adults 26 and older). In data on the amount they drank in the past month, nearly 19.7 percent or 7.4 million youth report that they consume 5 or more drinks per occasion - an amount that is often labeled "heavy episodic" drinking. Because alcohol is implicated in all kinds of behaviors that affect health, these statistics represent a serious public health dilemma. For example, in 2006 alcohol was involved in traffic accidents that killed 13,740 people in the U.S., almost one-third of all traffic fatalities (National Highway Traffic Safety Administration, 2008). About 1,900 of those who die annually in alcohol-related accidents were under the age of 21. While a number of influences may affect whether and how much youth drink, evidence suggests that alcohol advertising may play a role in drinking behavior. In 2006 alcohol manufacturers spent $1.3 billion advertising their products on television and in magazines (Center on Alcohol Monitoring and Youth, 2007). Until now, the alcohol industry, broadly defined, has regulated itself with respect to advertising. Despite this self-regulation, in 2006 an average youth saw 284 television and 90 magazine alcohol advertisements. Although there is a large empirical literature that investigates the relationship between drinking and advertising, few studies combine the data and study design required to identify whether advertising exposure causes people to drink more or whether the association is spurious. In this project we will use unique data on media people view to create new and improved measures of their exposure to alcohol advertisements and alcohol-related Public Service Announcements (PSAs) in magazines and on television. The goal of the project is to estimate whether exposure affects behavior influenced by alcohol. These behaviors include whether and how much people drink, whether they drink and drive, and the number alcohol-related traffic fatalities that occur in the US. We pay special attention to alcohol consumption, drinking and driving behavior of underage youth. PUBLIC HEALTH RELEVANCE: The project aims to estimate the causal relationship between exposure to alcohol advertising and individual decisions to drink, drink heavily, drink and drive, and ride with people who have been drinking. We will use unique data that track both mass media consumption and alcohol consumption. We use three independent data sources on drinking behavior to provide evidence from multiple samples.